Predictive values of age and the Glasgow Coma Scale in traumatic brain injury patients treated with decompressive craniectomy

Matthew Bryan Potts, John H. Chi, Michele Meeker, Martin C. Holland, J. Claude Hemphill, Geoffrey T. Manley

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Background The use of decompressive craniectomy (DC) as an aggressive therapy for traumatic brain injury (TBI) has gained renewed interest. While age and the Glasgow Coma Scale (GCS) are frequently correlated with outcome in TBI, their prognostic values after decompressive cra-niectomy are ill-defined. Methods We retrospectively reviewed data from 103 TBI patients treated with DC from 2001 to 2003. Age, preoper-ative GCS, and injury severity scores were recorded. Outcome at time of discharge was measured with the Glasgow Outcome Scale (GOS). Patients were stratified into the following age groups: <35, 35-49, 50-64, and ≥65 years. Spearman's correlation coefficients between age, GCS, and GOS were calculated for the entire population and each age group. Findings Mortality rates for each age group were 19.2%, 66.7%, 60%, and 80%, respectively. There was a significant negative correlation between age and GOS (r=-0.42, p< 0.0001) and patients <35 years had significantly better outcomes than patients ≥35 years (p<0.0001). The overall correlation between GCS and GOS did not reach significance (r=0.18, p=0.076). When stratified by age, there was a significant correlation between GCS and GOS only in patients 35-49 years (r=0.51, p=0.011). Conclusions This data suggests that in TBI patients treated with DC, age correlates with outcome while the correlation between GCS and outcome is age-dependent.

Original languageEnglish (US)
Title of host publicationIntracranial Pressure and Brain Monitoring XIII
Subtitle of host publicationMechanisms and Treatment
PublisherSpringer-Verlag Wien
Pages109-112
Number of pages4
Edition102
ISBN (Print)9783211855775
DOIs
StatePublished - Jan 1 2008

Publication series

NameActa Neurochirurgica, Supplementum
Number102
ISSN (Print)0065-1419

Keywords

  • Age
  • Brain injuries
  • Decompressive craniectomy
  • Glasgow Coma Scale

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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    Potts, M. B., Chi, J. H., Meeker, M., Holland, M. C., Hemphill, J. C., & Manley, G. T. (2008). Predictive values of age and the Glasgow Coma Scale in traumatic brain injury patients treated with decompressive craniectomy. In Intracranial Pressure and Brain Monitoring XIII: Mechanisms and Treatment (102 ed., pp. 109-112). (Acta Neurochirurgica, Supplementum; No. 102). Springer-Verlag Wien. https://doi.org/10.1007/978-3-211-85578-2_22